摘要
目的探讨甲状腺乳头状癌(PTC)原发灶CT值联合形态学预测其中央组淋巴结转移的价值。资料与方法选取经术后病理证实为单发PTC且行中央组淋巴结清扫术的340例患者,包括中央组淋巴结转移组178例,未转移组162例,测量术前所行CT增强扫描平扫期、动脉期和静脉期PTC原发灶的CT值,计算病灶动脉期及静脉期净增CT值和标准化CT值,比较两组各CT值的差异;分析原发灶影像形态学特征与中央组淋巴结转移的关系;计算原发灶标准化CT值联合其影像形态学特征的预测效能。结果中央组淋巴结转移组与未转移组间静脉期原发灶CT值、净增CT值及标准化CT值比较,差异均有统计学意义(P<0.05);临界值为107.5 Hu、53 Hu、0.761,敏感度分别为71.4%、76.2%、71.4%,特异度分别为81.8%、59.1%、72.7%;静脉期标准化CT值联合形态学预测中央组淋巴结转移的敏感度为72.5%,特异度为81.5%。结论 PTC原发病灶静脉期CT值联合其影像形态学在预测中央组淋巴结转移方面具有一定的价值。
Purpose To explore the combination of CT value and morphology of papillary thyroid carcinoma(PTC) in predicting central lymph node metastasis(CLNM). Materials and Methods 340 patients with PTC confirmed by postoperative pathology and received central lymph node dissection were selected, including 178 cases of central lymph node metastases and 162 cases without metastases. CT values of PTC primary lesions in scan period, arterial period and venous period of pre-operative enhanced CT were measured to calculate and compare net increase CT value and standard CT value in arterial period and venous period of lesions. The relationship between the imaging morphological features of primary lesions and CLN metastasis was analyzed, and the predictive efficiency of standard CT value combined imaging morphological features of primary lesions was calculated. Results Compared with nonmetastases group, The CT value of primary lesions in venous period, net increased CT value and standard CT value showed statistical significance between central lymph node metastases group and non-metastases group(P<0.05). The critical value was 107.5 Hu, 53 Hu and 0.761, respectively, the sensitivity was 71.4%, 76.2% and 71.4%, respectively;the specificity was 81.8%, 59.1% and 72.7%, respectively. The sensitivity and specificity of standard CT value in venous period combined morphology in predicting central lymph node metastasis were 72.5% and 81.5%, respectively. Conclusion CT value of PTC primary lesions in venous period is of great importance in predicting central lymph node metastases.
作者
闵蕊
韩丹
赵雯
李浚利
蔡雅倩
刘顼
MIN Rui;HAN Dan;ZHAO Wen;LI Junli;CAI Yaqian;LIU Xu(Department of Medical Imaging,the First Affiliated Hospital,Kunming Medical University,Kunming 650032,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2020年第3期184-188,共5页
Chinese Journal of Medical Imaging
基金
云南省科技厅科技计划项目[2019FE001(-213)]。
关键词
甲状腺肿瘤
癌
乳头状
体层摄影术
X线计算机
淋巴转移
Thyroid neoplasms
Carcinoma,papillary
Tomography,X-ray computed
Lymphatic metastasis
